04-26-1993 Council Packet - Laserfiche WebLink

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CITY JrOKONO u\- • *'1 (612) 473- Post Offic^J^ox 66 Crystal Bay, MN 55323 SEPTIC SYSTEM INSTALLEI LICENSE application 'APR l 5 All questions must be answered. License fee, bond, certificate of insurance, and evidence of MPCA Certification must be attached. All applications are subject to a ten (10) day approval period. 1. 2. 3. Business or trade name Business address /hAJ Business phone V jR"'HResidence phone Name of a certification representative holding MPCA 7. 8. 9. Type of certification held: ______ Installer Pximper Certificate expiration date L>j9S/ienJ Have you ever h^d a Septic System Installer license in Orono before? Most recent year <7A Have you ever had a license revo)ced? /7 ^_ _ When? _ _ _ _ __ Where? _ _ ___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _- Do you do Municipal Sewer hoc!.-ups? Yes Do you pump out septic tanks? Yes X y ary of om^ submittals required1 1. $50.00 License application fee. ^ 2. $2000.00 license and permit bond naming City of Ckm " ii umiPT-nm rigo,, $2000.00 license and permit nona naming uity oi uirono obligee. The State Plumbers Bond will not be «ccep^d. u 3. $50-100-300,000 minimum Certificate of Insurance. -^5^ 4. Copy of current MPCA Certificate. iS'T'W LICENSES WILL NOT BE PROCESSED UNTIL ALL ITEMS ARB SUBMITTED List persons other than applicant who are authorized by you to apply for permits under your license - - - - The undersigned hereby makes application to the City of Orono, Minnesota, for a license to install arJ repair septic systems, and/or pump out jeptic tanks, subject to the laws of the State of A’; ("'.esota and the Ordinances of the Date Applicant's Signature City of OroM, CITY USE ONLY Staff recommendation Approval Reason for denial: Denial Date City Council Action Date Date license mailed _ _ _ Approved Denied